SPARCS compliance reporting is changing. Here’s what you need to know now

SPARCS compliance reporting is changing. Here’s what you need to know now

The Statewide Planning and Research Cooperative System (SPARCS) is a comprehensive all payer data reporting system established by the New York State Department Of Health (NYSDOH).

The system is designed to collect patient level details such as patient demographics, diagnoses and treatments and charges for hospital inpatient stays and outpatient (ambulatory surgery, emergency department, and outpatient services) visits.

Facilities in New York are required to report data to SPARCS monthly to demonstrate compliance and avoid penalties.

Current data submission process

Under the current submission process, facilities submit SPARCS compliance data in an electronic, computer readable x12 837R format unique to requirements of the New York State. The data is transmitted to Department of Health’s Health Commerce System (HCS), where it is analyzed and response files are generated.

Revised data submission process

With the goal of standardizing data, the New York State Department Of Health (NYSDOH) will be using x225 837R format going forward. This is essentially x12 837I (standard used for submitting institutional claims) format with additional segment for race/ethnicity and NTE segment to collect source of payment and cardiac data elements.

NYSDOH has also partnered with Optum Government Solutions, Inc. for redesigning the processing system required for SPARCS.

Key points to consider:

Legacy system lack the utility to export data in 837I format. Facilities will need to check if their system provides data in the compatible format. If not, find a way to convert data into SPARCS compliant format.

The redesign of processing system may pose challenges with respect to the interface of the portal and method of submission within the portal.

NYSDOH is targeting complete implementation of the new system within 12 months.

Testing phase of SPARCS data submission in the new system begins on January 23rd 2018. Facilities can begin submitting test data to get comfortable with the nuances of the new submission method.

New format is applicable for Q4 2017 submissions and facilities are required to have at least one accepted claim for each claim type by April 30, 2018.

NYSDOH also requires 95% of the facility’s Q4 2017 data to be submitted as per the new format by June 30, 2018 and 100% of the facility’s Q4 2017 data to be submitted by Sep 30, 2018.

*Timelines are representative of current plan and are subject to change.

We have been working with several clients and helping them comply with Meaningful Use, PQRS, ASCQR, SPARCS, HCRA and THCIC compliance programs. We have already developed technology to convert data into new SPARCS compliant format. Click here to get in touch and explore further.